Escaping the spotlight

December 9, 2016 -- The new President has promised to repeal the Affordable Care Act (ACA/Obamacare). Fortunately, there are other important health care legislations that -- escaping the spotlight of campaign rhetoric -- are evading his attack. That's good because they, too, do things that are good for the American people. Here are a couple of them.

In 10/14, Medicare payment reform legislation (Medicare Access and CHIP Reauthorization Act, MACRA) was finalized. In essence, this law creates new, better ways for providers (mainly doctors) to be paid. Of these, perhaps the most radical is termed the Merit-Based Incentive Payment System. It creates incentives for quality (make more money when you give better care) and -- dear to the hearts of us informaticians -- substantial incentives for the use of electronic health records (EHRs).

This latter initiative -- that has propelled our health care system toward electronic in place of paper record-keeping -- has been driven by a program termed Meaningful Use. It is part of the Health Information Technology for Economic and Clinical Health (HITECH) Act, a component of Obama's economic stimulus package, crafted early in his first term, a year or so before the Affordable Care Act (Obamacare) was passed. Meaningful Use offered strong financial incentives to hospitals and to physician practices and has been effective indeed. In the seven years since HITECH was passed, adoption of EHRs by hospitals has gone from near zero to 96%.

Having escaped the spotlight, HITECH and MACRA are likely to survive the new President's push to "repeal and replace". And that's a good thing!

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